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Methylphenidate for Apathy in Community-Dwelling Older Veterans With Mild Alzheimer’s Disease: A Double-Blind, Randomized, Placebo-Controlled Trial
American Journal of Psychiatry ( IF 15.1 ) Pub Date : 2017-09-15
Prasad R. Padala, Kalpana P. Padala, Shelly Y. Lensing, Daniel Ramirez, Varun Monga, Melinda M. Bopp, Paula K. Roberson, Richard A. Dennis, Frederick Petty, Dennis H. Sullivan, William J. Burke

Objective:

Apathy is a common behavioral problem in Alzheimer’s disease. Apathy has profound consequences, such as functional impairment, higher service utilization, higher caregiver burden, and increased mortality. The authors’ objective was to study the effects of methylphenidate on apathy in Alzheimer’s disease.

Method:

A 12-week, prospective, double-blind, randomized, placebo-controlled trial (methylphenidate versus placebo) was conducted in community-dwelling veterans (N=60) with mild Alzheimer’s disease. The primary outcome for apathy (Apathy Evaluation Scale–Clinician) and secondary outcomes for cognition (Mini-Mental State Examination, Modified Mini-Mental State Examination), functional status (activities of daily living, instrumental activities of daily living), improvement and severity (Clinical Global Impressions Scale [CGI]), caregiver burden (Zarit Burden Scale), and depression (Cornell Scale for Depression in Dementia) were measured at baseline and at 4, 8, and 12 weeks.

Results:

Participants were all men (77 years old, SD=8). After adjusting for baseline, the methylphenidate group had significantly greater improvement in apathy than the placebo group at 4 weeks, 8 weeks, and 12 weeks. At 12 weeks, there was also greater improvement in cognition, functional status, caregiver burden, CGI scores, and depression in the methylphenidate group compared with the placebo group.

Conclusions:

Methylphenidate improved apathy in a group of community-dwelling veterans with mild Alzheimer’s disease. Methylphenidate also improved cognition, functional status, caregiver burden, CGI scores, and depression.



中文翻译:

哌醋甲酯用于患有轻度阿尔茨海默氏病的社区老兵的冷漠:双盲,随机,安慰剂对照试验

客观的:

冷漠是阿尔茨海默氏病中常见的行为问题。冷漠会产生深远的后果,例如功能受损,服务使用率提高,护理人员负担增加以及死亡率增加。作者的目的是研究哌醋甲酯对阿尔茨海默氏病冷漠的影响。

方法:

在患有轻度阿尔茨海默氏病的社区居住退伍军人(N = 60)中进行了一项为期12周的前瞻性,双盲,随机,安慰剂对照试验(哌醋甲酯与安慰剂)。冷漠的主要结局(冷漠评估量表-临床医生)和认知的次要结局(小精神状态检查,改良的小精神状态检查),功能状态(日常生活活动,日常生活的工具活动),改善和严重程度(临床总体印象量表[CGI]),照料者负担(Zarit负担量表)和抑郁症(痴呆症的康奈尔量表)在基线,第4、8和12周进行测量。

结果:

参加者均为男性(77岁,SD = 8)。调整基线后,哌醋甲酯组在4周,8周和12周时的冷漠改善明显大于安慰剂组。与安慰剂组相比,哌醋甲酯组在12周时的认知,功能状态,护理人员负担,CGI评分和抑郁水平也有了较大改善。

结论:

哌醋甲酯改善了一组患有轻度阿尔茨海默氏病的社区老兵的冷漠。哌醋甲酯还改善了认知,功能状态,护理人员负担,CGI评分和抑郁。

更新日期:2017-09-15
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